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From the outside, Steere House looks normal enough. The spacious three-story facility houses a nursing home and rehabilitation center in downtown Providence, R.I., right off Interstate 95. On the third floor, the Safe Haven Advanced Care unit has 41 rooms reserved for patients who have dementia. Nothing appears odd about the wing, until you get to know one of the house pets: a sweet-faced gray and white tabby named Oscar.

Oscar was adopted by the nursing home when he was a kitten and passed his first year rather uneventfully, playing with fellow feline adoptee, Maya, or entertaining himself out of the public eye. But shortly before his first birthday, he began visiting patients during their final hours. He’d take up a vigil on the beds, waiting quietly until the patient had passed away.

The nursing home employees soon began to realize he was the first “staffer” to know a patient was about to die. They took Oscar’s visits as a cue to notify the family and make final preparations. David Dosa, M.D., a Steere House geriatrician who treats the dementia patients and researches the illness at Brown University, wrote an essay about Oscar for the New England Journal of Medicine. The piece made international headlines—and propelled Oscar into unusual stardom.

Dosa then launched his own personal investigation to learn about the effect Oscar had on the people around him—namely the patient’s families. He relays what he found out in his new book, Making Rounds With Oscar. He spoke with the AARP Bulletin about it.

A. Absolutely not. I had had some bad experiences with cats growing up and that colored my perception of them and their importance.

Q. So what motivated you to investigate the Oscar effect?

A. I wanted to get a sense of what the families thought about having this cat sit at the bedside while their loved ones passed on. When I wrote the essay on Oscar, there was a fair amount of publicity. It was geared toward “if Oscar’s on your bed, you’re dead.” He was depicted as the grim reaper of cats.

Q. But you saw Oscar’s services in a different light?

A. We were seeing a cat that was providing families with a great deal of distraction—and comfort.

Q. In his five years living at Steere House, has he missed a death?

A. He’s been right most of the time. We’ve estimated that it’s over 60 at this point.

Q. You’re a scientist. Have you heard of a satisfactory explanation why Oscar does this?

A. What makes the most sense to me is he’s perceiving a smell or a pheromone. We know that when cells are in starvation states or in their final stages, they release ketones, which are sweet-smelling chemicals. Doctors are actually taught to smell them on the breaths of diabetics to determine if their sugars are really high. We also know ketones are released during hunger strikes or when people are at the end of one.

Q. But even if he does tune in to a smell, and “knows” when death is near, what makes him stay by the patient’s side?

A. I’ve interviewed a lot of people for this book, but Oscar wasn’t talking, so ultimately your guess is as good as mine.

Q. But what’s your guess?

A. I do think animals have an empathic relationship with people and Oscar is the resident pet for 41 patients on this unit. He seems to know when he’s needed. If he’s responding to a smell, that might be, but there’s something more to it because he doesn’t leave until the undertakers come.